低分子量肝素和未分离的肝素都有效地加速新生的肺血管成熟
Stacy B O'Blenes1, Sandra L Merklinger, Anusha Jegatheeswaran
1Division of Cardiovascular Surgery, The Hospital for Sick Children and The University of Toronto, Toronto, Ontario, Canada.
Circulation
|September 13, 2003
概括
肝素 (UFH和LMWH) 加快了新生的肺血管成熟. 这表明,在诺伍德手术后,肝素可以在低可塑性左心综合征的诺伍德手术后实现更早的双向空腔肺突变.
科学领域:
- 心血管研究研究心血管研究
- 儿童心脏病学 儿童心脏病学
- 新生儿生理学 新生儿生理学
背景情况:
- 低塑性左心综合征 (HLHS) 管理涉及延迟的洞肺突变创建,以允许肺血管抵抗降低.
- 肺血管床的成熟对于这种延迟至关重要.
- 肝素的特性 (血管生成促进,平滑肌肉细胞抑制) 可能会加速这种成熟.
研究的目的:
- 为了调查未分离的氨酸 (UFH) 和低分子量氨酸 (LMWH) 是否可以加速新生的肺血管成熟.
- 评估氨酸在缩短诺伍德手术后空腔肺短路转换时间方面的潜力.
主要方法:
- 56只新生子接受了皮下UFH,LMWH (两剂量) 或盐水14天.
- 测量了肺动脉压力,气膜:动脉比率和中间壁厚度.
- 肝素对肺血管成熟的影响与对照组进行了比较.
主要成果:
- 肝素治疗 (UFH,LMWH) 与盐水对照相比,显著降低了肺动脉平均压力 (12-16%).
- 较低的肺动脉压力与降低的膜:动脉比率相关,表明增强的肺动脉生成.
- 在接受肝素治疗的子中观察到肺动脉中间壁厚度和肌肉化的减少,这表明血管成熟的加速.
结论:
- UFH和LMWH都有效地加速了新生的肺血管成熟.
- 这些发现表明,诺伍德手术后的肝素给药可能会促进儿童更早地转换为双向腔肺突变.
- 氨酸可能会将肺血管成熟过程缩短60%以上.
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